BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in ...BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.展开更多
BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To ...BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To develop a risk prediction model for the pathological upgrading of gastric LGIN to aid clinical diagnosis and treatment.METHODS We retrospectively analyzed data from patients newly diagnosed with gastric LGIN who underwent complete endoscopic resection within 6 months at the First Medical Center of Chinese People’s Liberation Army General Hospital between January 2008 and December 2023.A risk prediction model for the pathological progression of gastric LGIN was constructed and evaluated for accuracy and clinical applicability.RESULTS A total of 171 patients were included in this study:93 patients with high-grade intraepithelial neoplasia or early gastric cancer and 78 with LGIN.The logistic stepwise regression model demonstrated a sensitivity and specificity of 0.868 and 0.800,respectively,while the least absolute shrinkage and selection operator(LASSO)regression model showed sensitivity and specificity values of 0.842 and 0.840,respectively.The area under the curve(AUC)for the logistic model was 0.896,slightly lower than the AUC of 0.904 for the LASSO model.Internal validation with 30%of the data yielded AUC scores of 0.908 for the logistic model and 0.905 for the LASSO model.The LASSO model provided greater utility in clinical decision-making.CONCLUSION A risk prediction model for the pathological upgrading of gastric LGIN based on white-light and magnifying endoscopic features can accurately and effectively guide clinical diagnosis and treatment.展开更多
Thermally conductive papers with electrical insulation and mechanical robustness are essential for efficient thermal management in modern electronics.In this study,we introduced a metal ion-assisted interfacial crossl...Thermally conductive papers with electrical insulation and mechanical robustness are essential for efficient thermal management in modern electronics.In this study,we introduced a metal ion-assisted interfacial crosslinking strategy to strengthen sugarfunctionalized graphene fluoride(SGF)and cellulose nanofibers(CNF)by hydrogen bonding and metal ion crosslinking that leads to simultaneous enhancements in thermal conductivity and mechanical properties.The facile sugarassisted ball-milling exfoliation method was developed to achieve the exfoliation of graphite fluoride and hydroxyl group functionalization on the surface of graphene fluoride.Thanks to the good dispersibility of the SGF sheets in water,the flexible SGF/CNF composite papers with hydrogen bonding were prepared via vacuum-assisted filtration.We introduced hydrogen bonding and metal ion crosslinking into SGF/CNF papers to obtain densely packed composite papers.Ca^(2+)or Al^(3+)ion-crosslinked SGF/CNF papers exhibited superior thermal and mechanical properties owing to hydrogen bonding and metal ion crosslinking.SGF/CNF-Ca^(2+)and SGF/CNF-Al^(3+)papers at 50 wt%of SGF yield in-plane thermal conductivities of 72.93 and 75.02 W m^(-1) K^(-1),and tensile strengths of 121.5 and 135.7 MPa,respectively.A thermal percolation value was observed at 12.6 vol%of SGF filler content.In addition,the SGF/CNF papers exhibited electrical insulation properties.These remarkable characteristics of the metal ion-crosslinked SGF/CNF papers are attributed to the densely packed structures caused by the strong interfacial interactions from hydrogen bonding as well as metal ion-crosslinking that could promote phonon transport.High-performance metal ion-crosslinked SGF/CNF papers with these fascinating advantages offer great potential for the thermal management of flexible electronics.展开更多
Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 ...Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 elderly COPD patients with pulmonary infection,treated between December 2022 and November 2023,were randomly divided into a control group and an observation group,with 40 cases in each group.The control group was treated with levofloxacin hydrochloride,while the observation group received ambroxol hydrochloride injection in addition to the treatment in the control group.Laboratory indices(white blood cell count,procalcitonin,C-reactive protein,and apolipoprotein E levels),imaging-based pulmonary lesion absorption time,hospital stay,and incidence of adverse reactions were compared between the two groups.Results:After treatment,the biochemical indices of the observation group were significantly lower than those of the control group,with highly significant differences(P<0.001).Compared to the control group,the imaging-based pulmonary lesion absorption time and hospital stay of the observation group were significantly shorter(P<0.001).Additionally,the incidence of adverse reactions in the observation group was significantly lower than in the control group(P<0.05).Conclusion:Levofloxacin combined with ambroxol demonstrates advantages in improving biochemical indices,shortening imaging-based pulmonary lesion absorption time and hospital stay,and reducing adverse reaction rates in elderly COPD patients with pulmonary infection.It holds significant clinical application value.展开更多
BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spi...BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spinal cord damage which in turn cause complications such as paraplegia and quadriplegia.In this study,we established a model using three concentrations of bacteria and carried out a comprehensive evaluation of the model by imaging,general observations,and histopathological and bacteriological studies.AIM To establish a rabbit model of spinal tuberculosis and examine the effect on the model’s efficacy using different concentrations of Mycobacterium tuberculosis(M.tuberculosis)inoculum.METHODS New Zealand rabbits were randomly divided into experimental,control and blank groups.The experimental and control animals were sensitized with complete Freund′s adjuvant,a hole was drilled beneath the upper endplate of the L6 vertebral body and filled with gelfoam sponge.The experimental group was divided into three subgroups(experimental 1,experimental 2,experimental 3)and infused with M.tuberculosis suspension at various concentrations.The control group was inoculated with saline and the blank group received no treatment.The 12-week post-operative survival rates were 100%,80%and 30%in the experimental groups inoculated with concentrations of 106,107 and 108 CFU/mL bacteria,respectively.RESULTS The survival rate of the control and blank groups was 100%.Vertebral body destruction at 8 weeks in the three experimental groups as determined by X-ray analysis was 33.3%,62.5%and 66.7%,and by computed tomography(CT)and 3-dimensional CT 44.4%,75%and 100%,respectively.At 12 weeks,the figures were 44.4%,75%and 100%by X-ray analysis and 44.4%,100%and 100%by CT and 3-dimensional CT,respectively.All surviving rabbits of the experimental groups had vertebral destruction.The positive bacterial culture rates were 22.2%,75%and 66.7%,respectively,in the experimental groups.After being sensitized with complete Freund's adjuvant,large differences were observed in the extent of spinal tuberculosis after inoculation of the rabbits with different concentrations of H37RV standard M.tuberculosis.CONCLUSION The experimental 1 had a low success rate at establishing an infection.The experimental 3 resulted in high mortality and complication rates.The experimental 2 was optimum for establishing a spinal tuberculosis model based on the high level of symptoms observed and the low rabbit mortality.展开更多
Traffic engineering such as tunnels in various altitudinal gradient zone are at risk of accidental explosion,which can damage personnel and equipment.Accurate prediction of the distribution pattern of explosive loads ...Traffic engineering such as tunnels in various altitudinal gradient zone are at risk of accidental explosion,which can damage personnel and equipment.Accurate prediction of the distribution pattern of explosive loads and shock wave propagation process in semi-enclosed structures at various altitude environment is key research focus in the fields of explosion shock and fluid dynamics.The effect of altitude on the propagation of shock waves in tunnels was investigated by conducting explosion test and numerical simulation.Based on the experimental and numerical simulation results,a prediction model for the attenuation of the peak overpressure of tunnel shock waves at different altitudes was established.The results showed that the peak overpressure decreased at the same measurement points in the tunnel entrance under the high altitude condition.In contrast,an increase in altitude accelerated the propagation speed of the shock wave in the tunnel.The average error between the peak shock wave overpressure obtained using the overpressure prediction formula and the measured test data was less than15%,the average error between the propagation velocity of shock waves predicted values and the test data is less than 10%.The method can effectively predict the overpressure attenuation of blast wave in tunnel at various altitudes.展开更多
This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy...This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy,in treating advanced hepatocellular carcinoma(HCC).The potential application of this combination therapy for patients with advanced HCC is evaluated.展开更多
BACKGROUND Rheumatic immune diseases are a group of chronic inflammatory diseases charac-terized by joint and systemic multi-organ involvement,including rheumatoid arthritis,systemic lupus erythematosus,and Sjogren’s...BACKGROUND Rheumatic immune diseases are a group of chronic inflammatory diseases charac-terized by joint and systemic multi-organ involvement,including rheumatoid arthritis,systemic lupus erythematosus,and Sjogren’s syndrome,among others.The pathogenesis of these diseases is related to the abnormal activation and regulatory imbalance of the immune system.The prevalence and morbidity of rheumatic immune diseases are high,imposing a significant burden on patients'quality of life and socio-economic costs.Currently,the treatment of rheumatic immune diseases mainly relies on Western medicine,such as non-steroidal anti-inflammatory drugs,glucocorticoids,disease-modifying antirheumatic drugs,and biologics.However,the therapeutic effects of Western medicine are not ideal,some patients poorly respond or are resistant to Western medicine,and long-term use often causes various adverse reactions.AIM To systematically evaluate the efficacy and safety of Tripterygium wilfordii gly-cosides tablets combined with Western medicine in the treatment of patients with rheumatic immune diseases.METHODS This study conducted a meta-analysis to systematically evaluate the efficacy and safety of Tripterygium wilfordii glycosides tablets combined with Western medicine for patients with rheumatic immune diseases.Chinese and English databases were searched for randomized controlled trials(RCTs)on the treatment of rheumatic immune diseases with Tripterygium wilfordii glycosides tablets combined with Western medicine.The quality of the included studies was assessed using the Cochrane risk of bias assessment tool.Meta-analysis was performed using RevMan 5.4 software.RESULTS The meta-analysis included 11 RCTs involving 1026 patients with rheumatic immune diseases.The combined treatment significantly reduced the risk of disease recurrence(relative risk=1.07,95%confidence interval:1.01-1.15,P<0.05)and showed no significant heterogeneity(I2=0%,P=0.53),indicating that Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective method to reduce the possibility of postoperative recurrence in patients with rheumatic immune diseases.However,due to the limited number and quality of the studies included,these results should be interpreted with caution.CONCLUSION Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective and safe treatment option for patients with rheumatic immune diseases and can be considered a clinical choice.However,more high-quality research is needed to validate this conclusion and provide more solid evidence for clinical practice.展开更多
BACKGROUND The induced-membrane technique was initially described by Masquelet as an effective treatment for large bone defects,especially those caused by infection.Here,we report a case of chronic osteomyelitis of th...BACKGROUND The induced-membrane technique was initially described by Masquelet as an effective treatment for large bone defects,especially those caused by infection.Here,we report a case of chronic osteomyelitis of the radius associated with a 9 cm bone defect,which was filled with a large allogeneic cortical bone graft from a bone bank.Complete bony union was achieved after 14 months of follow-up.Previous studies have used autogenous bone as the primary bone source for the Masquelet technique;in our case,the exclusive use of allografts is as successful as the use of autologous bone grafts.With the advent of bone banks,it is possible to obtain an unlimited amount of allograft,and the Masquelet technique may be further improved based on this new way of bone grafting.CASE SUMMARY In this study,we reported a case of repair of a long bone defect in a 40-year-old male patient,which was characterized by the utilization of allograft cortical bone combined with the Masquelet technique for the treatment of the patient's long bone defect in the forearm.The patient's results of functional recovery of the forearm were surprising,which further deepens the scope of application of Masquelet technique and helps to strengthen the efficacy of Masquelet technique in the treatment of long bones indeed.CONCLUSION Allograft cortical bone combined with the Masquelet technique provides a new method of treatment to large bone defect.展开更多
Stress granules are membraneless organelles that serve as a protective cellular response to external stressors by sequestering non-translating messenger RNAs(mRNAs)and regulating protein synthesis.Stress granules form...Stress granules are membraneless organelles that serve as a protective cellular response to external stressors by sequestering non-translating messenger RNAs(mRNAs)and regulating protein synthesis.Stress granules formation mechanism is conserved across species,from yeast to mammals,and they play a critical role in minimizing cellular damage during stress.Composed of heterogeneous ribonucleoprotein complexes,stress granules are enriched not only in mRNAs but also in noncoding RNAs and various proteins,including translation initiation factors and RNA-binding proteins.Genetic mutations affecting stress granule assembly and disassembly can lead to abnormal stress granule accumulation,contributing to the progression of several diseases.Recent research indicates that stress granule dynamics are pivotal in determining their physiological and pathological functions,with acute stress granule formation offering protection and chronic stress granule accumulation being detrimental.This review focuses on the multifaceted roles of stress granules under diverse physiological conditions,such as regulation of mRNA transport,mRNA translation,apoptosis,germ cell development,phase separation processes that govern stress granule formation,and their emerging implications in pathophysiological scenarios,such as viral infections,cancer,neurodevelopmental disorders,neurodegeneration,and neuronal trauma.展开更多
ZIZHITONGJIAN is a key historical work that reflects not only political events but also many culture-loaded expressions rooted in traditional Chinese life.These expressions,including official titles,ritual words,and h...ZIZHITONGJIAN is a key historical work that reflects not only political events but also many culture-loaded expressions rooted in traditional Chinese life.These expressions,including official titles,ritual words,and historical references,carry strong cultural meaning that is hard to translate.And these words are often described as culture-loaded words.Previous research on ZIZHITONGJIAN has offered valuable insights into its translation,focusing on general strategies,historical context,or selected passages.However,these discussions often remain broad in scope,lacking systematic comparison across different types of English editions.This study uses Hu Gengshen’s eco-translatology theory to explore how these culture-loaded words are handled in three kinds of English editions by listing out some classical examples.By applying eco-translatology,this study identifies common translation issues across different English editions and offers a methodological reference for future research on classical Chinese texts,especially in handling culture-loaded words with greater cultural and communicative sensitivity.展开更多
In this article,we comment on the work put forth by Wu et al regarding the investigation of oesophageal cancer-specific mortality for a cohort of patients from Chongqing University Cancer Hospital.We specifically focu...In this article,we comment on the work put forth by Wu et al regarding the investigation of oesophageal cancer-specific mortality for a cohort of patients from Chongqing University Cancer Hospital.We specifically focused on the implications of public health plans such as Urban Employee Basic Medical Insurance(UEBMI)and Urban Resident Basic Medical Insurance as well as out-of-pocket ratios on patient treatment plans regarding whether they pursue surgical interventions or therapeutic treatments such as chemotherapy.While Wu et al put forth potential explanations for why patients with the UEBMI plan surprisingly had a 23.30%increased risk of oesophageal cancer-specific death,more analysis is needed to alleviate cancer burden within this group.Although it is likely that patients covered by Urban Resident Basic Medical Insurance and higher out-ofpocket ratios have stronger self-recovery awareness,more work must be done to improve outcomes for people with the UEBMI plan while simultaneously implementing international and domestic initiatives to better emphasize cancer prevention and early detection.Lastly,future research must explore the relationship between Serious Illness Medical Insurance as well as the New Rural Cooperative Medical System on the mortality rate of oesophageal cancer patients in rural China,where disease burden is significantly higher than urban areas.By unifying these public health insurance schemes,officials can significantly alleviate economic burden of treatment and better prognosis for patients with oesophageal cancer.展开更多
Based on panel data from 31 Chinese provinces during 2010–2022,this study constructs a systematic theoretical framework incorporating clean energy investment,technological innovation,industrial structure optimization...Based on panel data from 31 Chinese provinces during 2010–2022,this study constructs a systematic theoretical framework incorporating clean energy investment,technological innovation,industrial structure optimization,and environ-mental governance,employing spatial econometric and threshold effect models to examine the impact mechanisms of clean energy development on sustainable economic growth.The findings reveal that clean energy development has a significant promoting effect on sustainable economic growth(impact coefficient 0.437)and generates notable spatial spillover effects(coefficient 0.328);technological innovation(38.24%),industrial structure optimization(31.47%),and environmental gov-ernance(25.89%)represent three crucial pathways through which clean energy drives sustainable economic development;this impact exhibits significant regional heterogeneity,with the eastern region(0.526)showing higher effects than central(0.437)and western regions(0.342),and demonstrating a strengthening trend over time.The innovative contributions of this paper include:the first combination of spatial econometrics and threshold effect models to study the economic effects of clean energy development;construction of a detailed measurement system for clean energy development that incorporates characteristics of different types of clean energy;and quantitative analysis of the inherent causes of regional differences using the Shapley value decomposition method.The research conclusions provide a theoretical foundation and practical guidance for formulating differentiated regional development strategies,strengthening technological innovation support,optimizing the industrial development environment,and enhancing environmental governance coordination.展开更多
This study examines how training opportunities influence teachers’job satisfaction,emphasizing the mediating effect of AI self-efficacy among primary and secondary school teachers in Wuhan,China.Current research empl...This study examines how training opportunities influence teachers’job satisfaction,emphasizing the mediating effect of AI self-efficacy among primary and secondary school teachers in Wuhan,China.Current research employed a quantitative,cross-sectional design.Data were collected using an online questionnaire from 655 primary and secondary school teachers in Wuhan.Structural equation modelling(PLS-SEM)was utilized for data analysis.Results confirmed significant positive relationships between training opportunities and both AI self-efficacy and job satisfaction.Besides,AI self-efficacy was found to significantly mediate the relationship between training opportunities and job satisfaction.This study contributes to the body of knowledge by empirically showed the relatively unexplored psychological pathway(AI self-efficacy)linking training opportunities to job satisfaction within AI-intensive educational contexts.The findings enhance understanding of how structured training in AI can positively influence teachers’attitudes and job-related outcomes.Educational policymakers and administrators can utilise these findings to develop specialised training programs,thereby improving teacher self-efficacy,job satisfaction and overall effectiveness in responding to technology changes.展开更多
Under the background of exam-oriented education in China,art education has been marginalized,and the career success of junior middle school art teachers is being challenged.The influencing factors have become a topic ...Under the background of exam-oriented education in China,art education has been marginalized,and the career success of junior middle school art teachers is being challenged.The influencing factors have become a topic worthy of exploration.Therefore,this study aims to investigate the influence on career success and career self-development among junior middle school art teachers in Shenzhen,China.This study conducted a questionnaire survey among junior middle school art teachers in Shenzhen,China.The results show that career self-management affects the career success of art teachers.On this basis,this study proposes some strategies to help the group of art teachers achieve higher career success by improving their career self-management levels.展开更多
Escalating anthropogenic activities have caused heavy metal contamination in the environmental matrices.Due to their recalcitrant and toxic nature,their occurrence in high titers in the environment can threaten surviv...Escalating anthropogenic activities have caused heavy metal contamination in the environmental matrices.Due to their recalcitrant and toxic nature,their occurrence in high titers in the environment can threaten survival of biotic components.To take the edge off,remediation of metal-contaminated sites by phytoremediators that exhibit a potential to withstand heavy metal stress and quench harmful metals is considered an eco-sustainable approach.Despite the enormous potential,phytoremediation technique suffers a setback owing to high metal concentrations,occurrence of multiple pollutants,low plant biomass,and soil physicochemical status that affect plants at cellular and molecular levels,inducing morphological,physiological,and genetic alterations.Nevertheless,augmentation of soil with microorganisms can alleviate the challenge.A positive nexus between microbes,particularly plant growth-promoting microorganisms(PGPMs),and phytoremediators can prevent phytotoxicity and augment phytoremediation by employing strategies such as production of secondary metabolites,solubilization of phosphate,and synthesis of 1-aminocyclopropane-1-carboxylic acid(ACC)deaminase and phytohormones.Microbes can mediate tolerance in plants by fortifying their antioxidant machinery,which maintains redox homeostasis and alleviates metal-induced oxidative damage in the plants.Associated microbes can also activate stress-responsive genes in plants and abridge metal-induced toxic effects.An in-depth exploration of the mechanisms employed by plant-associated microbes to trigger tolerance in phytoremediators is crucial for improving their phytoremediation potential and real-world applications.The present article attempts to comprehensively review these mechanisms that eventually facilitate the development of improved/new technology for soil ecosystem restoration.展开更多
The red cultural resources in rural areas bear the heavy historical and spiritual strength,and are the key rich ore and spiritual pillar in the field of education.This study discusses the connotation of red culture re...The red cultural resources in rural areas bear the heavy historical and spiritual strength,and are the key rich ore and spiritual pillar in the field of education.This study discusses the connotation of red culture resources and the current situation of educating people,and then analyzes how to integrate interdisciplinary learning theory into red culture to enhance the value of educating people.On this basis,it proposes to explore the educational path of optimizing rural red cultural resources from an interdisciplinary perspective by integrating multi-disciplinary knowledge and red cultural resources.展开更多
Congenital gastric ectopic pylorus(CGEP),also known as gastric ectopic pyloric opening,is a rare congenital gastric abnormality.It was first reported and termed by Yu and Zhao from China in 1983,and in 2007,Uraz et al...Congenital gastric ectopic pylorus(CGEP),also known as gastric ectopic pyloric opening,is a rare congenital gastric abnormality.It was first reported and termed by Yu and Zhao from China in 1983,and in 2007,Uraz et al published the first report of CGEP in the English literature.We conducted a systemic review of the literature of CGEP published in English or Chinese,and found that CGEP occurred more frequently in the 6th and 7th decade of life,with a male predominance(89.7%).The majority of reported cases(89.2%)were from East Asia,and the underlying mechanism remains unknown.Most patients with CGEP presented non-specific symptoms,including abdominal pain,bloating,regurgitation,and belching.A few patients(30%)experienced upper gastrointestinal bleeding.Given the non-specific symptoms,misdiagnosis or underdiagnosis often occurs.Gastroscopy and upper gastrointestinal radiography are the main examinations used to confirm the diagnosis.Currently,conservative medication is the mainstay treatment.In this systematic review,we describe the history,etiology,diagnosis and treatment of CGEP in detail,aiming to provide a comprehensive understanding of this rare disease and avoid misdiagnosis.展开更多
This retrospective case study investigates the clinical presentation of a 53-year-old female who underwent mantle field radiotherapy roughly 26 years ago. This patient presents with diffuse muscle atrophy and weakness...This retrospective case study investigates the clinical presentation of a 53-year-old female who underwent mantle field radiotherapy roughly 26 years ago. This patient presents with diffuse muscle atrophy and weakness in the cervical musculature, as well as sensory deficits in the upper extremities. We sought to compare our patient’s symptoms with other patients who had been formally diagnosed with Dropped Head Syndrome (DHS) by reviewing the existing literature. We found that the clinical presentation under investigation was consistent with other patients who had received radiotherapy for Hodgkins’s disease and were then diagnosed with DHS. Electromyography (EMG), nerve conduction studies, and a cervical MRI were unable to identify a separate neurological cause for the symptoms, but the MRI did confirm the presence of diffuse muscle atrophy in the cervical musculature. After reviewing the existing literature and imaging results, we compared our patient’s symptoms to those that define DHS, and both the time of onset, presenting symptoms, and progressing course are consistent with a diagnosis of Dropped Head Syndrome.展开更多
Amidst the unique challenges faced by rural educators is their sense of decent work influenced by levels of social support,career self-efficacy,and marginalization.To investigate these relationships,we surveyed 435 ru...Amidst the unique challenges faced by rural educators is their sense of decent work influenced by levels of social support,career self-efficacy,and marginalization.To investigate these relationships,we surveyed 435 rural school teachers(females=69.32%,mean years teaching experience=13.6,SD=7.7 years).The Structural Equation Modeling results indicated that social support positively predicts teachers’perceptions of decent work.Career self-efficacy mediated the relationship between social support and a higher sense of decent work,while marginalization mediated the relationship such that lower social support predicted lower perceptions of decent work.Career self-efficacy and marginalization also had a sequential mediation relationship:higher social support enhanced career self-efficacy,which in turn reduced marginalization experiences,ultimately improving teachers’perceptions of decent work.These findings align with the predictions of Social Cognitive Career Theory and the Psychology of Working Theory,demonstrating that environmental supports enhance personal psychological resources,reduce marginalization risks,and promote positive work-related outcomes.The study findings highlight the necessity for education departments to improve rural teachers’perceptions of decent work by providing social support to foster positive work experiences for teachers at high risk for marginalization and diminished career self-efficacy.展开更多
文摘BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.
基金Supported by the National Key Research and Development Program of China,No.2022YFC2503600。
文摘BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To develop a risk prediction model for the pathological upgrading of gastric LGIN to aid clinical diagnosis and treatment.METHODS We retrospectively analyzed data from patients newly diagnosed with gastric LGIN who underwent complete endoscopic resection within 6 months at the First Medical Center of Chinese People’s Liberation Army General Hospital between January 2008 and December 2023.A risk prediction model for the pathological progression of gastric LGIN was constructed and evaluated for accuracy and clinical applicability.RESULTS A total of 171 patients were included in this study:93 patients with high-grade intraepithelial neoplasia or early gastric cancer and 78 with LGIN.The logistic stepwise regression model demonstrated a sensitivity and specificity of 0.868 and 0.800,respectively,while the least absolute shrinkage and selection operator(LASSO)regression model showed sensitivity and specificity values of 0.842 and 0.840,respectively.The area under the curve(AUC)for the logistic model was 0.896,slightly lower than the AUC of 0.904 for the LASSO model.Internal validation with 30%of the data yielded AUC scores of 0.908 for the logistic model and 0.905 for the LASSO model.The LASSO model provided greater utility in clinical decision-making.CONCLUSION A risk prediction model for the pathological upgrading of gastric LGIN based on white-light and magnifying endoscopic features can accurately and effectively guide clinical diagnosis and treatment.
基金supported by the Basic Science Program(No.2022R1A2C2009700)through the National Research Foundation of Korea(NRF)funded by the Ministry of Science and ICTthe Basic Science Research Capacity Enhancement Project(National Research Facilities and Equipment Center)through the Korea Ba-sic Science Institute funded by the Ministry of Education(No.2019R1A6C1010047)the Industrial Strategic Technology Development Program(No.20013248)through Korea Evaluation In-stitute of Industrial Technology funded by the Ministry of Trade,Industry&Energy(MOTIE,Korea).
文摘Thermally conductive papers with electrical insulation and mechanical robustness are essential for efficient thermal management in modern electronics.In this study,we introduced a metal ion-assisted interfacial crosslinking strategy to strengthen sugarfunctionalized graphene fluoride(SGF)and cellulose nanofibers(CNF)by hydrogen bonding and metal ion crosslinking that leads to simultaneous enhancements in thermal conductivity and mechanical properties.The facile sugarassisted ball-milling exfoliation method was developed to achieve the exfoliation of graphite fluoride and hydroxyl group functionalization on the surface of graphene fluoride.Thanks to the good dispersibility of the SGF sheets in water,the flexible SGF/CNF composite papers with hydrogen bonding were prepared via vacuum-assisted filtration.We introduced hydrogen bonding and metal ion crosslinking into SGF/CNF papers to obtain densely packed composite papers.Ca^(2+)or Al^(3+)ion-crosslinked SGF/CNF papers exhibited superior thermal and mechanical properties owing to hydrogen bonding and metal ion crosslinking.SGF/CNF-Ca^(2+)and SGF/CNF-Al^(3+)papers at 50 wt%of SGF yield in-plane thermal conductivities of 72.93 and 75.02 W m^(-1) K^(-1),and tensile strengths of 121.5 and 135.7 MPa,respectively.A thermal percolation value was observed at 12.6 vol%of SGF filler content.In addition,the SGF/CNF papers exhibited electrical insulation properties.These remarkable characteristics of the metal ion-crosslinked SGF/CNF papers are attributed to the densely packed structures caused by the strong interfacial interactions from hydrogen bonding as well as metal ion-crosslinking that could promote phonon transport.High-performance metal ion-crosslinked SGF/CNF papers with these fascinating advantages offer great potential for the thermal management of flexible electronics.
文摘Objective:To investigate the clinical efficacy of levofloxacin combined with ambroxol in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods:A total of 80 elderly COPD patients with pulmonary infection,treated between December 2022 and November 2023,were randomly divided into a control group and an observation group,with 40 cases in each group.The control group was treated with levofloxacin hydrochloride,while the observation group received ambroxol hydrochloride injection in addition to the treatment in the control group.Laboratory indices(white blood cell count,procalcitonin,C-reactive protein,and apolipoprotein E levels),imaging-based pulmonary lesion absorption time,hospital stay,and incidence of adverse reactions were compared between the two groups.Results:After treatment,the biochemical indices of the observation group were significantly lower than those of the control group,with highly significant differences(P<0.001).Compared to the control group,the imaging-based pulmonary lesion absorption time and hospital stay of the observation group were significantly shorter(P<0.001).Additionally,the incidence of adverse reactions in the observation group was significantly lower than in the control group(P<0.05).Conclusion:Levofloxacin combined with ambroxol demonstrates advantages in improving biochemical indices,shortening imaging-based pulmonary lesion absorption time and hospital stay,and reducing adverse reaction rates in elderly COPD patients with pulmonary infection.It holds significant clinical application value.
基金Supported by Lanzhou City Science and Technology Development Guiding Plan Project,No.2023-ZD-170Lanzhou Science and Technology Plan Project,No.2023-2-11High-Level Talent Training Project At the 940th Hospital of the Joint Logistics Force,No.2024-G3-5.
文摘BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spinal cord damage which in turn cause complications such as paraplegia and quadriplegia.In this study,we established a model using three concentrations of bacteria and carried out a comprehensive evaluation of the model by imaging,general observations,and histopathological and bacteriological studies.AIM To establish a rabbit model of spinal tuberculosis and examine the effect on the model’s efficacy using different concentrations of Mycobacterium tuberculosis(M.tuberculosis)inoculum.METHODS New Zealand rabbits were randomly divided into experimental,control and blank groups.The experimental and control animals were sensitized with complete Freund′s adjuvant,a hole was drilled beneath the upper endplate of the L6 vertebral body and filled with gelfoam sponge.The experimental group was divided into three subgroups(experimental 1,experimental 2,experimental 3)and infused with M.tuberculosis suspension at various concentrations.The control group was inoculated with saline and the blank group received no treatment.The 12-week post-operative survival rates were 100%,80%and 30%in the experimental groups inoculated with concentrations of 106,107 and 108 CFU/mL bacteria,respectively.RESULTS The survival rate of the control and blank groups was 100%.Vertebral body destruction at 8 weeks in the three experimental groups as determined by X-ray analysis was 33.3%,62.5%and 66.7%,and by computed tomography(CT)and 3-dimensional CT 44.4%,75%and 100%,respectively.At 12 weeks,the figures were 44.4%,75%and 100%by X-ray analysis and 44.4%,100%and 100%by CT and 3-dimensional CT,respectively.All surviving rabbits of the experimental groups had vertebral destruction.The positive bacterial culture rates were 22.2%,75%and 66.7%,respectively,in the experimental groups.After being sensitized with complete Freund's adjuvant,large differences were observed in the extent of spinal tuberculosis after inoculation of the rabbits with different concentrations of H37RV standard M.tuberculosis.CONCLUSION The experimental 1 had a low success rate at establishing an infection.The experimental 3 resulted in high mortality and complication rates.The experimental 2 was optimum for establishing a spinal tuberculosis model based on the high level of symptoms observed and the low rabbit mortality.
基金financially supported by National Natural Science Foundation of China(Grant Nos.52378401,52278504)the Fundamental Research Funds for the Central Universities(Grant No.30922010918)。
文摘Traffic engineering such as tunnels in various altitudinal gradient zone are at risk of accidental explosion,which can damage personnel and equipment.Accurate prediction of the distribution pattern of explosive loads and shock wave propagation process in semi-enclosed structures at various altitude environment is key research focus in the fields of explosion shock and fluid dynamics.The effect of altitude on the propagation of shock waves in tunnels was investigated by conducting explosion test and numerical simulation.Based on the experimental and numerical simulation results,a prediction model for the attenuation of the peak overpressure of tunnel shock waves at different altitudes was established.The results showed that the peak overpressure decreased at the same measurement points in the tunnel entrance under the high altitude condition.In contrast,an increase in altitude accelerated the propagation speed of the shock wave in the tunnel.The average error between the peak shock wave overpressure obtained using the overpressure prediction formula and the measured test data was less than15%,the average error between the propagation velocity of shock waves predicted values and the test data is less than 10%.The method can effectively predict the overpressure attenuation of blast wave in tunnel at various altitudes.
文摘This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy,in treating advanced hepatocellular carcinoma(HCC).The potential application of this combination therapy for patients with advanced HCC is evaluated.
文摘BACKGROUND Rheumatic immune diseases are a group of chronic inflammatory diseases charac-terized by joint and systemic multi-organ involvement,including rheumatoid arthritis,systemic lupus erythematosus,and Sjogren’s syndrome,among others.The pathogenesis of these diseases is related to the abnormal activation and regulatory imbalance of the immune system.The prevalence and morbidity of rheumatic immune diseases are high,imposing a significant burden on patients'quality of life and socio-economic costs.Currently,the treatment of rheumatic immune diseases mainly relies on Western medicine,such as non-steroidal anti-inflammatory drugs,glucocorticoids,disease-modifying antirheumatic drugs,and biologics.However,the therapeutic effects of Western medicine are not ideal,some patients poorly respond or are resistant to Western medicine,and long-term use often causes various adverse reactions.AIM To systematically evaluate the efficacy and safety of Tripterygium wilfordii gly-cosides tablets combined with Western medicine in the treatment of patients with rheumatic immune diseases.METHODS This study conducted a meta-analysis to systematically evaluate the efficacy and safety of Tripterygium wilfordii glycosides tablets combined with Western medicine for patients with rheumatic immune diseases.Chinese and English databases were searched for randomized controlled trials(RCTs)on the treatment of rheumatic immune diseases with Tripterygium wilfordii glycosides tablets combined with Western medicine.The quality of the included studies was assessed using the Cochrane risk of bias assessment tool.Meta-analysis was performed using RevMan 5.4 software.RESULTS The meta-analysis included 11 RCTs involving 1026 patients with rheumatic immune diseases.The combined treatment significantly reduced the risk of disease recurrence(relative risk=1.07,95%confidence interval:1.01-1.15,P<0.05)and showed no significant heterogeneity(I2=0%,P=0.53),indicating that Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective method to reduce the possibility of postoperative recurrence in patients with rheumatic immune diseases.However,due to the limited number and quality of the studies included,these results should be interpreted with caution.CONCLUSION Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective and safe treatment option for patients with rheumatic immune diseases and can be considered a clinical choice.However,more high-quality research is needed to validate this conclusion and provide more solid evidence for clinical practice.
文摘BACKGROUND The induced-membrane technique was initially described by Masquelet as an effective treatment for large bone defects,especially those caused by infection.Here,we report a case of chronic osteomyelitis of the radius associated with a 9 cm bone defect,which was filled with a large allogeneic cortical bone graft from a bone bank.Complete bony union was achieved after 14 months of follow-up.Previous studies have used autogenous bone as the primary bone source for the Masquelet technique;in our case,the exclusive use of allografts is as successful as the use of autologous bone grafts.With the advent of bone banks,it is possible to obtain an unlimited amount of allograft,and the Masquelet technique may be further improved based on this new way of bone grafting.CASE SUMMARY In this study,we reported a case of repair of a long bone defect in a 40-year-old male patient,which was characterized by the utilization of allograft cortical bone combined with the Masquelet technique for the treatment of the patient's long bone defect in the forearm.The patient's results of functional recovery of the forearm were surprising,which further deepens the scope of application of Masquelet technique and helps to strengthen the efficacy of Masquelet technique in the treatment of long bones indeed.CONCLUSION Allograft cortical bone combined with the Masquelet technique provides a new method of treatment to large bone defect.
基金supported by a grant from the Merkin Peripheral Neuropathy and Nerve Regeneration Center(to PKS)the Rutgers University Startup Fund(to PKS).
文摘Stress granules are membraneless organelles that serve as a protective cellular response to external stressors by sequestering non-translating messenger RNAs(mRNAs)and regulating protein synthesis.Stress granules formation mechanism is conserved across species,from yeast to mammals,and they play a critical role in minimizing cellular damage during stress.Composed of heterogeneous ribonucleoprotein complexes,stress granules are enriched not only in mRNAs but also in noncoding RNAs and various proteins,including translation initiation factors and RNA-binding proteins.Genetic mutations affecting stress granule assembly and disassembly can lead to abnormal stress granule accumulation,contributing to the progression of several diseases.Recent research indicates that stress granule dynamics are pivotal in determining their physiological and pathological functions,with acute stress granule formation offering protection and chronic stress granule accumulation being detrimental.This review focuses on the multifaceted roles of stress granules under diverse physiological conditions,such as regulation of mRNA transport,mRNA translation,apoptosis,germ cell development,phase separation processes that govern stress granule formation,and their emerging implications in pathophysiological scenarios,such as viral infections,cancer,neurodevelopmental disorders,neurodegeneration,and neuronal trauma.
文摘ZIZHITONGJIAN is a key historical work that reflects not only political events but also many culture-loaded expressions rooted in traditional Chinese life.These expressions,including official titles,ritual words,and historical references,carry strong cultural meaning that is hard to translate.And these words are often described as culture-loaded words.Previous research on ZIZHITONGJIAN has offered valuable insights into its translation,focusing on general strategies,historical context,or selected passages.However,these discussions often remain broad in scope,lacking systematic comparison across different types of English editions.This study uses Hu Gengshen’s eco-translatology theory to explore how these culture-loaded words are handled in three kinds of English editions by listing out some classical examples.By applying eco-translatology,this study identifies common translation issues across different English editions and offers a methodological reference for future research on classical Chinese texts,especially in handling culture-loaded words with greater cultural and communicative sensitivity.
文摘In this article,we comment on the work put forth by Wu et al regarding the investigation of oesophageal cancer-specific mortality for a cohort of patients from Chongqing University Cancer Hospital.We specifically focused on the implications of public health plans such as Urban Employee Basic Medical Insurance(UEBMI)and Urban Resident Basic Medical Insurance as well as out-of-pocket ratios on patient treatment plans regarding whether they pursue surgical interventions or therapeutic treatments such as chemotherapy.While Wu et al put forth potential explanations for why patients with the UEBMI plan surprisingly had a 23.30%increased risk of oesophageal cancer-specific death,more analysis is needed to alleviate cancer burden within this group.Although it is likely that patients covered by Urban Resident Basic Medical Insurance and higher out-ofpocket ratios have stronger self-recovery awareness,more work must be done to improve outcomes for people with the UEBMI plan while simultaneously implementing international and domestic initiatives to better emphasize cancer prevention and early detection.Lastly,future research must explore the relationship between Serious Illness Medical Insurance as well as the New Rural Cooperative Medical System on the mortality rate of oesophageal cancer patients in rural China,where disease burden is significantly higher than urban areas.By unifying these public health insurance schemes,officials can significantly alleviate economic burden of treatment and better prognosis for patients with oesophageal cancer.
文摘Based on panel data from 31 Chinese provinces during 2010–2022,this study constructs a systematic theoretical framework incorporating clean energy investment,technological innovation,industrial structure optimization,and environ-mental governance,employing spatial econometric and threshold effect models to examine the impact mechanisms of clean energy development on sustainable economic growth.The findings reveal that clean energy development has a significant promoting effect on sustainable economic growth(impact coefficient 0.437)and generates notable spatial spillover effects(coefficient 0.328);technological innovation(38.24%),industrial structure optimization(31.47%),and environmental gov-ernance(25.89%)represent three crucial pathways through which clean energy drives sustainable economic development;this impact exhibits significant regional heterogeneity,with the eastern region(0.526)showing higher effects than central(0.437)and western regions(0.342),and demonstrating a strengthening trend over time.The innovative contributions of this paper include:the first combination of spatial econometrics and threshold effect models to study the economic effects of clean energy development;construction of a detailed measurement system for clean energy development that incorporates characteristics of different types of clean energy;and quantitative analysis of the inherent causes of regional differences using the Shapley value decomposition method.The research conclusions provide a theoretical foundation and practical guidance for formulating differentiated regional development strategies,strengthening technological innovation support,optimizing the industrial development environment,and enhancing environmental governance coordination.
文摘This study examines how training opportunities influence teachers’job satisfaction,emphasizing the mediating effect of AI self-efficacy among primary and secondary school teachers in Wuhan,China.Current research employed a quantitative,cross-sectional design.Data were collected using an online questionnaire from 655 primary and secondary school teachers in Wuhan.Structural equation modelling(PLS-SEM)was utilized for data analysis.Results confirmed significant positive relationships between training opportunities and both AI self-efficacy and job satisfaction.Besides,AI self-efficacy was found to significantly mediate the relationship between training opportunities and job satisfaction.This study contributes to the body of knowledge by empirically showed the relatively unexplored psychological pathway(AI self-efficacy)linking training opportunities to job satisfaction within AI-intensive educational contexts.The findings enhance understanding of how structured training in AI can positively influence teachers’attitudes and job-related outcomes.Educational policymakers and administrators can utilise these findings to develop specialised training programs,thereby improving teacher self-efficacy,job satisfaction and overall effectiveness in responding to technology changes.
文摘Under the background of exam-oriented education in China,art education has been marginalized,and the career success of junior middle school art teachers is being challenged.The influencing factors have become a topic worthy of exploration.Therefore,this study aims to investigate the influence on career success and career self-development among junior middle school art teachers in Shenzhen,China.This study conducted a questionnaire survey among junior middle school art teachers in Shenzhen,China.The results show that career self-management affects the career success of art teachers.On this basis,this study proposes some strategies to help the group of art teachers achieve higher career success by improving their career self-management levels.
基金the financial support from the project of the Ministry of Science and Higher Education of Russian Federation on the Young Scientist Laboratory within the framework of the Interregional Scientific and Educational Center of the South of Russia(No.FENW-2024-0001)the Strategic Academic Leadership Program of the Southern Federal University,Russia(Priority 2030)the Science and Engineering Research Board,Govt.of India for providing financial assistance(SERB/EEQ/2021/000735)。
文摘Escalating anthropogenic activities have caused heavy metal contamination in the environmental matrices.Due to their recalcitrant and toxic nature,their occurrence in high titers in the environment can threaten survival of biotic components.To take the edge off,remediation of metal-contaminated sites by phytoremediators that exhibit a potential to withstand heavy metal stress and quench harmful metals is considered an eco-sustainable approach.Despite the enormous potential,phytoremediation technique suffers a setback owing to high metal concentrations,occurrence of multiple pollutants,low plant biomass,and soil physicochemical status that affect plants at cellular and molecular levels,inducing morphological,physiological,and genetic alterations.Nevertheless,augmentation of soil with microorganisms can alleviate the challenge.A positive nexus between microbes,particularly plant growth-promoting microorganisms(PGPMs),and phytoremediators can prevent phytotoxicity and augment phytoremediation by employing strategies such as production of secondary metabolites,solubilization of phosphate,and synthesis of 1-aminocyclopropane-1-carboxylic acid(ACC)deaminase and phytohormones.Microbes can mediate tolerance in plants by fortifying their antioxidant machinery,which maintains redox homeostasis and alleviates metal-induced oxidative damage in the plants.Associated microbes can also activate stress-responsive genes in plants and abridge metal-induced toxic effects.An in-depth exploration of the mechanisms employed by plant-associated microbes to trigger tolerance in phytoremediators is crucial for improving their phytoremediation potential and real-world applications.The present article attempts to comprehensively review these mechanisms that eventually facilitate the development of improved/new technology for soil ecosystem restoration.
基金Supported by the Research Project of Jiangsu Second Normal University"Research on the Construction and Application of Economics MOOC(Micro Course)from the Perspective of Ideological and Political Education JSSNUJXGG 2023YB08".
文摘The red cultural resources in rural areas bear the heavy historical and spiritual strength,and are the key rich ore and spiritual pillar in the field of education.This study discusses the connotation of red culture resources and the current situation of educating people,and then analyzes how to integrate interdisciplinary learning theory into red culture to enhance the value of educating people.On this basis,it proposes to explore the educational path of optimizing rural red cultural resources from an interdisciplinary perspective by integrating multi-disciplinary knowledge and red cultural resources.
基金Supported by National Key Research and Development Project,No.2022YFC2503603and 985th Hospital Research Project,No.YN202405.
文摘Congenital gastric ectopic pylorus(CGEP),also known as gastric ectopic pyloric opening,is a rare congenital gastric abnormality.It was first reported and termed by Yu and Zhao from China in 1983,and in 2007,Uraz et al published the first report of CGEP in the English literature.We conducted a systemic review of the literature of CGEP published in English or Chinese,and found that CGEP occurred more frequently in the 6th and 7th decade of life,with a male predominance(89.7%).The majority of reported cases(89.2%)were from East Asia,and the underlying mechanism remains unknown.Most patients with CGEP presented non-specific symptoms,including abdominal pain,bloating,regurgitation,and belching.A few patients(30%)experienced upper gastrointestinal bleeding.Given the non-specific symptoms,misdiagnosis or underdiagnosis often occurs.Gastroscopy and upper gastrointestinal radiography are the main examinations used to confirm the diagnosis.Currently,conservative medication is the mainstay treatment.In this systematic review,we describe the history,etiology,diagnosis and treatment of CGEP in detail,aiming to provide a comprehensive understanding of this rare disease and avoid misdiagnosis.
文摘This retrospective case study investigates the clinical presentation of a 53-year-old female who underwent mantle field radiotherapy roughly 26 years ago. This patient presents with diffuse muscle atrophy and weakness in the cervical musculature, as well as sensory deficits in the upper extremities. We sought to compare our patient’s symptoms with other patients who had been formally diagnosed with Dropped Head Syndrome (DHS) by reviewing the existing literature. We found that the clinical presentation under investigation was consistent with other patients who had received radiotherapy for Hodgkins’s disease and were then diagnosed with DHS. Electromyography (EMG), nerve conduction studies, and a cervical MRI were unable to identify a separate neurological cause for the symptoms, but the MRI did confirm the presence of diffuse muscle atrophy in the cervical musculature. After reviewing the existing literature and imaging results, we compared our patient’s symptoms to those that define DHS, and both the time of onset, presenting symptoms, and progressing course are consistent with a diagnosis of Dropped Head Syndrome.
文摘Amidst the unique challenges faced by rural educators is their sense of decent work influenced by levels of social support,career self-efficacy,and marginalization.To investigate these relationships,we surveyed 435 rural school teachers(females=69.32%,mean years teaching experience=13.6,SD=7.7 years).The Structural Equation Modeling results indicated that social support positively predicts teachers’perceptions of decent work.Career self-efficacy mediated the relationship between social support and a higher sense of decent work,while marginalization mediated the relationship such that lower social support predicted lower perceptions of decent work.Career self-efficacy and marginalization also had a sequential mediation relationship:higher social support enhanced career self-efficacy,which in turn reduced marginalization experiences,ultimately improving teachers’perceptions of decent work.These findings align with the predictions of Social Cognitive Career Theory and the Psychology of Working Theory,demonstrating that environmental supports enhance personal psychological resources,reduce marginalization risks,and promote positive work-related outcomes.The study findings highlight the necessity for education departments to improve rural teachers’perceptions of decent work by providing social support to foster positive work experiences for teachers at high risk for marginalization and diminished career self-efficacy.
